1980, 05-16 Permit: 80-4882 ResidencePLAN NUMBER
Mw
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
S. il'?)
LOT BLOCK
k
b( D t�UFf DP
SUBDIVISION
t�aNDE2�lA •_7�-N
LEGAL DESCRIPTION — SEE ATTACHED
OWNER
3 AN'i Z W M . -Th-P-2 \S
PHONE
ate.
ADDRESS
‘4410-Z_ S10:=,
CONTRACTOR
ZIP
ctc-lZ l
PARCEL
NUMBER/S
32545 --c c i'a o38S
Actual Set Backs in Feet
North
q��jjp4 South 20'
t
East 4c IWest /3&i
4 PrMTcc,SAbywN
PHONE
Size of Parcel
Zone Classification
' ADDRESS
4ArnE
ZI P
Type Const. Occupancy
A a%. Si&bi,t2.6fk61
Sprinklered
Dyes ❑No ❑ Req'd.
5.
DESIGNER
PHONE
ADDRESS
ZIP
Ejaluation
yO -�dC�
Main Ftoor
(32-c
CHANGE OF USE FROM
6.
TO
Building Area in Sq. Ft.
Upper Floors Garage Area
gel
Area of Decks Finished Basement
Storage
Unfin. Basement
TYPE
7. OF
WORK
NEW ❑ ALT.
'BLD. ❑ PLMB.
❑ AD N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
Z•5
No. Stories
Z
No. Rooms
No. of Dwellings
k
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
DESCRIBE WORK
8.S % 't Fl1414' t .j RETS 1 DEfacc_ ciAAL,
grVALUATION SOURCE GAS ELECTRIC 1W TER
/ l O F yt�
tC d7t9UTILITIES
Enum. Dist. I Location (Area)
SEWER
Ownership
Public ❑ Private CI
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law egulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPEC1'\ONS—TT
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. alth
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
--ro m TL WATV s-) % g
SEPA Checklist
Idi g Technician
! f . 5,/v:80 / S/c
FD
SIGNATURE OF APPLICAN
SPECIAL CONDITIONS:
C.
Lt ce A & aK
ice
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building 344'. OZ)
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ 74-67'4X)
iP Z340/ NUMB V QCT
02* *30600
* 34600 tz
* 346006
E *0.00 0
488.18
05-1400
6479,
M
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
6-80
DATE ISSUED
488.2 *346,00° -
PERMIT NO. TOTAL